Emergency Dentist Archives - Page 3 of 6

My dental crown keeps falling off

Posted on October 9, 2020 by AllSmiles.

My dentist did a root canal on an upper right tooth about 12 years ago. Two years ago, the crown fell off, and my dentist replaced it. Since that time, the crown fell off three times, and my dentist cemented it back on. But my crown still feels a little loose. Not much tooth is left beneath the crown. Is this recementing something that I need to accept? The next time it falls off, I’m tempted to find a completely different dentist who takes urgent appointments to see if they can do any better than my dentist.

Thanks. Rebeka from Virginia

Rebeka,

When a crown keeps falling off, the problem is usually the design of the crown preparation. If that’s true in your case, you might need a new crown.

When a Root Canal Tooth Is Badly Broken

When a root canal tooth doesn’t have much structure left, a dentist can’t prepare the tooth properly. Some dentists use this method to improve crown retention:

Remove some of the root canal filler material
Place a flexible fiberglass post about 2/3 the tooth length into the canal and cement it in place
Bond core material to the post and tooth
Bond the crown to the built-up tooth

It won’t help to see another dentist for an emergency appointment because your situation can’t be corrected that quickly. The resolution takes forethought, time, and skill. The photographs on this page, courtesy of Dentistry Today, are an example of a treatment option that might work for your case.

If a dentist builds up your tooth with a post and composite, the tooth should retain a crown. But you need some remaining tooth structure for this to work. If crown retention only comes from the post, normal function and twisting stress will break the post, and the crown will fall off.

Look for an experienced dentist, schedule a consultation, and ask about treatment options.

Ryan Perry DDS, a Baton Rouge family dentist, sponsors this post.

Root canal tooth hurting again?

Posted on September 28, 2020 by AllSmiles.

Almost three years ago, I had a root canal on an upper right molar. In May, the tooth started hurting on and off. I hesitated to do anything about it because I didn’t want to go to the dentist during the pandemic. But now the pain isn’t on and off. It’s just on and getting worse. I don’t want to lose the tooth. I’m not an established patient with any dentist. Part of my hesitancy is that after a dental cleaning and exam last October, I became very ill the next day with what resulted in a month-long respiratory infection. I still have some chest congestion from it. I’m convinced that I got the infection from the dental office. I decided not to return to that office, but now with a throbbing toothache, I’ll have to find a new dentist. In the middle of Covid-19, I don’t want to keep switching dentists. I want an idea of what’s going on. And can you tell me what to expect from a dentist for treatment options? What’s the best treatment is for a root canal tooth that’s aching? Thanks for your input. Demetrius from Montgomery, AL

Demetrius,

We understand your hesitancy about going to a dentist. Your failed root canal treatment and illness after a dental appointment can create anxiety. But you likely realize that your throbbing tooth won’t improve without help from a dentist. So what’s causing your pain?

What Is Root Canal Failure?

Diagram of tooth with needing a root canal treatment — Although root canal treatment is usually successful, it sometimes fails

Root canal failure is a condition that occurs when a tooth doesn’t heal completely after root canal treatment. Symptoms eventually resurface and get worse. About one in ten teeth experience root canal failure.

Although Dr. Perry has extensive experience in root canal treatment, he would need to examine your tooth for an accurate diagnosis, it seems that root canal failure is causing your pain.

Why Are the Causes of Root Canal Failure?

Root canal treatment can sometimes fail for several reasons:

It’s impossible to see deep inside a tooth.
Some teeth have curved, branching roots that are difficult to clean.
If a dentist misses some of the infection in curved roots, symptoms will resurface.
Curvy, challenging roots require specialized rotary instruments to clean them out. Many general dentists don’t have those tools, so they may not completely clear the tooth. You may be referred to a specialist to complete root canal treatment.

What Is the Treatment for Root Canal Failure?

Treatment for root canal failure is either to perform another root canal treatment or root canal surgery. Most general dentists don’t have advanced training in this area, so an endodontist, or root canal specialist, usually completes the work. The specialist will identify the location of the infection that the dentist missed the first time and remove it or seal it off. Many root canal specialists say that retreatment has a 50% success rate, but the results are often better.

A specialist will also examine the condition of your tooth. If it’s cracked, the chances of saving your tooth decrease. Don’t delay treatment. Search online for a dentist with experience in root canal treatment who will see you right away, examine your tooth, and refer you to a specialist if needed.

Ryan Perry, DDS, of Baton Rouge sponsors this post.

Is it okay to wait almost a month to get an infected tooth extracted?

Posted on August 5, 2020 by AllSmiles.

Two weeks ago, I saw a specialist who says that my lower right first molar has a root fracture. I had a root canal on the tooth almost four years ago. The tooth is abscessed, sensitive, and somewhat painful. I have a bad taste in my mouth, and the infection is making me feel foggy and tired. My appointment for an extraction and implant is on the 1^st of next month. I’ve asked for a sooner date because of the discomfort and brain fog. But the specialist can’t see many any sooner. Is it dangerous for me to keep waiting or should I find another specialist? – Thanks. Jonathan from AZ

Jonathan,

Your symptoms, including pain, discomfort, fatigue, and brain fog, are good reasons not to wait. Those factors can put you at risk for other ailments or issues, so do what you can to receive the extraction sooner than a month.

Is It Dangerous to Wait for Your Tooth Extraction?

You asked if it’s dangerous to wait for the extraction. While you’re waiting for tooth extraction, the infection can grow and spread deeper. Although Dr. Perry would need to examine your tooth, the infection probably won’t cause serious complications. But complications can occur, and other than the specialist’s schedule, there is no reason to wait. You can get rid of the annoying symptoms sooner than next month.

Man frowning and holding the side of his face; for Baton Rouge emergency dentistry from Dr. Ryan Perry. — You can find a dentist to get you in faster and relieve your discomfort

Since you didn’t mention what type of specialist you’ve seen, we assume that it’s an oral surgeon. Extracting a lower right first molar isn’t usually complicated, so you don’t need an oral surgeon to remove it. You can ask the dentist who gave you the referral to refer you to another specialist. Or you can call an oral surgeon or a general dentist who will see you faster and perform the extraction. Unless there is an unusual problem with your tooth other than the fractured root, a general dentist who frequently extracts teeth can remove it.

And if you look for a general dentist with advanced training in implantology, you can stay with the practice to receive implant placement and a dental crown. It will save you the time and frustration of visiting multiple providers to resolve the issue completely.

Best wishes.

Ryan Perry DDS, a Baton Rouge family dentist, sponsors this post.

Sensitivity After Tooth Extraction – When You Should Be Concerned

Posted on May 18, 2020 by AllSmiles.

I’ve been running every morning for 12 years, and for the first time, last month, I fell. I fractured my left elbow, chipped two teeth, and broke the third tooth. The fractured tooth was bleeding intensely. I saw a dentist before I realized my elbow was fractured. I chose a dentist close to home because my regular dentist is 45 minutes away, and I didn’t know how much time I had. Anyway, the dentist extracted the tooth. The site is still achy sometimes, and it’s sensitive to warm or hot drinks and food. I notice it more after I walk. The extraction space looks okay. It’s just sensitive. I’m beginning to worry and regret going to a nearby dentist. Will the sensitivity decrease, or do I need to see my dentist before my appointment to restore my chipped teeth? Thanks. Jackson from Nashville, TN

Jackson,

After root canal treatment, your dentist will protect the tooth with the crown. You didn’t make a mistake by getting an emergency appointment with a nearby dentist. Whenever there is trauma to a tooth, it should be treated right away.

After physical exertion, if you’ve had a recent tooth extraction, it’s normal for the extraction site to hurt. Sensitivity to heat is not normal. Your symptoms are most likely coming from an adjacent tooth.

Sensitivity in a Tooth After Extraction

Sensitivity to cold – After an extraction, sensitivity to cold or air usually comes from the adjacent tooth. During extraction, sometimes the roots of an adjacent tooth are exposed, and that creates sensitivity. Mild sensitivity to cold isn’t a serious concern.

Sensitivity to heat – Persistent irritation in a tooth adjacent to one that was extracted can make it sensitive to heat. The tooth might be sensitive to cold at first, but irritation and inflammation will suffocate the pulp tissue inside the tooth until it dies. Inflammation can cause sensitivity to heat. Dying pulp tissue releases gases and heat that are confined within the tooth and become sensitive or painful.

As the tissue and nerves in the tooth die, sensitivity and achiness go away. But the infection doesn’t. The tooth will need root canal treatment, and your dentist will do the following:

Remove the dead tissue
Disinfect and clean the tooth
Replace the tissue with a filler material
Seal the tooth
Protect it with a dental crown

Yes, schedule an appointment with your dentist for an exam and an x-ray. You’ll probably need root canal treatment, but it will save the tooth and prevent another extraction.

Baton Rouge family dentist, Ryan Perry, DDS, sponsors this post.

Teeth Notches, Clenching, and Fillings that Pop Out

Posted on April 7, 2020 by AllSmiles.

I have a history of worn teeth and notches on the side near my gums. When I lived in LA, my dentist did fillings and bonding on them, and it held up beautifully for almost 17 years. For the past two years, I’ve been to three different dentists who replaced the bonding and fillings, but the bonding keeps falling out. A few times, the tooth exposure caused so much sensitivity that I made emergency appointments, but that’s not practical. About five weeks ago, my current dentist replaced two of the white fillings, and one filling is loose. I’ve decided not to keep putting up with sloppy work. If I start asking for refunds, maybe the dentist will be more careful. Are five weeks too long to wait to ask for a refund? Should I ask for more bonding or just get crowns? Thank you. Wade

Wade,

Repeat dental visits and lost fillings are frustrating and time-consuming. Flexing and clenching your teeth causes the notches—abfraction lesions—on the side of teeth near the gumline.

Flexible Composite for Long-Lasting Fillings in Teeth Under Stress

Cosmetic dentists who have received advanced training in restorative materials understand that the composite used in your teeth must be flexible. Although a general or family dentist would think that the material needs to be hard and stiff to withstand the forces of clenching or grinding your teeth, hard materials dislodge, as you’ve experienced.

A comparison of composites

Microfills – Flexible composite, like microfill, will prevent lost-filling episodes. Some brands that yield success are Siluz Plus or Renamel. The materials will flex with your teeth and last several years if bonded correctly.

Hybrid or microhybrid – Newer hybrid or microhybrid composites don’t flex well, which may explain why you’re the fillings placed by your dentist in LA lasted so long.

You can share this information with your dentist, and it might be enough. If he’s unwilling to try it and preserve your teeth, you can ask for a calmly ask for a refund. As you mentioned, it’s not practical to continually schedule urgent visits for fillings that pop out.

Even if your dentist isn’t willing to refund you for the fillings you received five weeks ago, look for an advanced cosmetic dentist to do the work. Don’t seek a family dentist for convenience or lower fees. You want results that will last, and a cosmetic dentist knows how to achieve long-lasting, natural-looking results.

Dr. Ryan Perry, a Baton Rouge dentist, sponsors this post.

How Some Advanced Dentists Save a Vertically Fractured Tooth

Posted on January 8, 2020 by AllSmiles.

I’m running out of time. After splitting my tooth, I’ve been to three dentists in the last three days who say the only option is to extract it. I want to save my tooth. How can I find a dentist willing to give it a try and not just remove the tooth? How do I know that it can’t be saved? Thanks. Daniel from Tulsa, OK

Daniel,

Sometimes it is possible to save a fractured tooth. But the tooth needs immediate attention. If a dentist can save the tooth can be saved, the fracture must be treated within a day or two. Although you didn’t tell us when your tooth was fractured, if it’s been at least three days, it’s too late to save the tooth.

Saving a Tooth with a Vertical Fracture

If the fracture is vertical, some advanced dentists have had success with the following technique:

Remove all debris from the fracture
Fit the pieces of the tooth together precisely
Apply bonding to the surface
Prepare the tooth for a crown and keep the segments immobile
After the tooth is stable, determine if endodontic treatment is needed
Protect the tooth with a durable dental crown
Schedule regular checkups to ensure the tooth is stable and not infected

For details, read a reprint of the article, Restoration of fractured teeth—a long-term study on mynewsmile.com. Although it may be too late to save your tooth, it’s not too late to share the research with the dentists you visited.

After Extraction

No form of tooth replacement is as effective as a natural tooth, but a dental implant is a good substitute. Implant components mimic natural teeth. The artificial root is a stable foundation for a new dental crown.

Entrust your extraction to a skilled general dentist or oral surgeon and find a dentist who has completed extensive post-graduate training in dental implants. You’ll get long-lasting results that look natural.

Dr. Ryan Perry, a Baton Rouge dentist, sponsors this post.

Is Chest Pain Related to a Toothache?

Posted on December 8, 2019 by ectree.

Hello there,

My grandmother is getting up there in age, but she dislikes going to the hospital and distrusts doctors. She’s in good health, but has started complaining of both a toothache and chest pain. She says that the chest pain is not new, but the toothache is.

Is chest pain along with a toothache an issue when you get older? Is it an emergency? Does she need to go to the doctor, or the dentist?

Travis, from Rochester, MA

Hi Travis,

A toothache and chest pain can mean a heart attack. You need to have her checked right away!

In a heart attack, the patient can have pain in the left arm or in the left jaw. Jaw pain is felt in about 10% of the cases. And remember that, due to how nerves travel through the body, everyone’s symptoms can be different. Instead of facial pain, you may experience a toothache, as pain can radiate through the lower left part of jaw, or across the lower arch. Despite your grandmother’s resistance, this is urgent and important.

Dental issues are not limited to the mouth. Good oral health and good cardiovascular health are linked. On the flip side, those with extensive gum disease are at risk for diabetes or cardiovascular disease.

Once your grandmother is better, you should take her to see a family dentist regularly. Regular assessments will cut down on the emergency dental trips, as well.

This blog post is brought to you by Baton Rouge emergency dentist, Dr. Ryan Perry.

Emergency – My Porcelain Crown Cracked!

Posted on November 8, 2019 by ectree.

Hi there,

I have had porcelain crowns for ages, and one of them has always had a horizontal line towards the bottom. It’s a tiny flaw, and not easily noticeable. However, after biting something hard, I can see the line much more clearly. I can also feel the line with my tongue, too. I am scared I will lose the tooth altogether. Does this fracture warrant a trip to the emergency dentist? Or can should I wait until I can see my cosmetic dentist again?

Willem, from Ballard, Utah

Hi Willem,

While you should see a cosmetic dentist as soon as possible to replace the crown, you do not have to see an emergency dentist. This may be a cosmetic emergency, but emergency dentists are better for accidents, severe pain, or infections.

What you describe as a flaw in your crown is actually a common occurrence. The horizontal line is called a craze line, and naturally occurs in both teeth and porcelain. Your crown was fine with this line, but now that you can feel it, that means some sort of shift has occurred. You will have to get the crown replaced before any other shifts happen.

Since you have had these crowns for ‘ages’, as you said, your cosmetic dentist may recommend that you replace all of them along with the cracked one. This is a good way to ensure that the replacement for the cracked crown matches the rest of your dental work. However, if there is nothing structurally wrong with your other crowns, it is not necessary to replace them. A master ceramist at a quality dental lab can match the color of your new crown to your current ones; an inexperienced cosmetic dentist will insist on replacing all the crowns, as they lack the necessary skill in painting and color matching porcelain.

This blog post is brought to you by Baton Rouge emergency dentist, Dr. Ryan Perry.

What Can I Do About a Tooth Infection?

Posted on October 15, 2019 by ectree.

Hello there,

I am in a bit of a predicament. My job does not provide and medical or dental insurance. However, I’ve been battling with what I think is a tooth infection. My face is swollen and puffy, and it aches all the time. My job doesn’t pay a lot, so I don’t have the money to treat this. What can I do?

Christopher, from Kansas City, Kansas

Hello Christopher,

It does sound like you have a tooth infection. Your infection may start to drain, which would release some of the swelling you feel, but it probably will not do that without any intervention.

Many communities have low-cost or mobile dental clinics, or allow you to pay on a sliding scale. You can start calling offices to see who is willing to work with you. Universities often have low-cost clinics. However, if your pain becomes worse, you should go to see an emergency dentist. Oral infections, if left untreated, can spread to other parts of your body. If it spreads to your brain, it can become very serious.

While you are looking for a clinic, do not try to treat the infection with antibiotics on your own. Antibiotics cannot treat infections present inside of teeth, only the swelling. You will likely need a root canal or an extraction to fully rid your mouth of the infection. If you take an antibiotic without any sort of treatment plan, the infection may come back, and when it does, it will be resistant to antibiotics. This will make curing the infection even more difficult.

This blog post is brought to you by Baton Rouge emergency dentist, Dr. Ryan P. Perry.

Why Aren’t Antibiotics Working?

Posted on June 15, 2019 by ectree.

Hi,

I was prescribed antibiotics by my dentist for a possible tooth infection. My gums were red and painful, and even my face was swollen a bit. I’ve taken them a few times a day for the past two weeks. The swelling went down for awhile, but now it’s back and worse than before. My cheek is swollen and yellow-ish, and there’s a weird taste in my mouth. Do I need to go to an emergency dentist? I’m not sure what they will do besides give me more antibiotics. What else can I do?

Thank you,

Jake, from Big Arm, Montana

Hi Jake,

I’m sorry to hear about your situation. Antibiotics aren’t the only treatment for tooth infections – they are a part of it. Once the infection is under control, then your dentist start your treatment plan. One treatment would be to extract the tooth, but a more common treatment is a root canal, which would open and drain the source of the infection. Once your infection is cleaned out, you should feel relief. Your infection sounds serious, so it’s unclear why your dentist has not done anything about it. If your pain worsens, go see an emergency dentist.

It sounds like your dentist does not fully understand tooth infections. Infections come when the organic material inside your tooth dies. Antibiotics are one treatment, but dead tissue receives no circulation, so a root canal or extraction is necessary. The antibiotics alone cannot clear out the infection. If you just take antibiotics without any treatment plan, you risk creating antibiotic-resistant bacteria in your mouth. This can cause complications, so you want to follow-up with your dentist, or a second opinion from an emergency dentist.

This blog post is brought to you by Baton Rouge emergency dentist, Dr. Ryan P. Perry.